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Table 4 Recommendations stated in the ten clinical practice guidelines

From: Systematic review of clinical practice guidelines in the diagnosis and management of thyroid nodules and cancer

Recommendations AACE/AME/ETA (2010) ATA (2009) BTA (2007) ESMO (2012) GAES (2013) IKNL (2007) LATS (2009) NCCN (2013) NCN (2000) SEOM (2011)
Indications of fine-needle aspiration (without suspicions) n >1 cm n >0.5 cm n >0.5 cm n >1 cm All nodules All nodules N/A n >1.5 cm All nodules n >1 cm
Routine serum calcitonin Optional NR N/A R R R Optional Optional Optional R
Thyroid scan Low TSH Follicular lesion with low TSH N/A Unclear Before operation NR N/A Follicular lesion with low TSH Unclear NR
Indication of total thyroidectomy for DTC N/A n >1 cm n >1 cm n >1 cm n >1 cm n >1 cm All sizes n >4 cm n >1 cm n >4 cm
Cervical lymph node dissection (node negative) N/A n >4 cm n >4 cm/male/age >45 years Optional Optional N/A n >4 cm Optional Unclear Optional
Postoperative care
Indication of I131 ablation N/A n >4 cm/high-risk patients High-risk patients n >2 cm/high-risk patients N/A High-risk patients High-risk patients Tg >1 ng/ml/high-risk patients n >1 cm High-risk patients
Target level of TSH suppression therapy (mU/L)           
High risk N/A <0.1 <0.1 <0.1 N/A <0.1 <0.1 <0.1 0.01 to 0.1 <0.1
Low risk N/A 0.1 to 0.5 0.1 to 0.5 WNL N/A   0.4 to 1.0 Close to the lower limit   <0.1 to 0.5
  1. Guideline group abbreviations are as follows: AACE/AME/ETA American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi and European Thyroid Association, ATA American Thyroid Association, BTA British Thyroid Association and Royal College of Physicians, ESMO European Society for Medical Oncology, GAES German Association of Endocrine Surgeons, IKNL Dutch Endocrine Society and Dutch Society of Nuclear Medicine, LATS Latin American Thyroid Society, NCCN National Comprehensive Cancer Network, NCN Northern Cancer Network and SEOM Spanish Society of Medical Oncology.
  2. DTC differentiated thyroid cancer, I iodine, n nodule, N/A not available, NR not recommended, R recommended, Tg thyroglobulin, TSH thyroid stimulating hormone, WNL within normal limit.